Background: The cause of aortic dissection could be a degenerative disorder of the connective tissue. We have previously shown that patients with abdominal aortic aneurysm have increased incidence of renal simple cyst. We hypothesized that the presence of renal simple cysts, another possible manifestation of connective tissue weakness, is associated with the increased risk of aortic dissection.
Methods: In order to evaluate this possible association, a retrospective study was conducted comparing incidence of renal cysts on CT scan. We reviewed 488 patients with aortic dissection (group A) and 1367 healthy subjects (group C) who underwent CT as a routine healthy screening from 1994 to 2006 at our institute. Multiple logistic regression test was performed to evaluate the association of aortic dissection with renal cysts.
Result: Group A had significantly more smoking, hypertension, older age, male preponderance, higher CRP and lower HDL cholesterol (p<0.001). Among patients in group A, 37.7% had renal cysts compared with 21.9% in group C (p<0.001). Bilateral involvement (p=0.001), number (p<0.001) and summation of size (p<0.011) of renal cysts were significantly higher in group A as compared with group C. As age increases, incidence of renal cysts were higher in group A compared to group C. Multivariate analysis revealed four independent predictors of aortic dissection; age (odds ratio (OR): 1.05), smoking (OR: 2.81), hypertension (OR: 11.63), and renal simple cyst (OR: 1.42).
Conclusion: Patients with aortic dissection have increased burden of renal simple cysts compared to healthy control. The structural weakness predisposing for renal simple cysts may be associated with aortic dissection. Prospective study is needed to determine aortic dissection and renal simple cysts do in fact have a common pathogenesis and the presence of renal cysts can be considered as a risk factor of aortic dissection.